Dr. Amanda Green, Chief Medical Officer at Paris Regional Medical Center

COMMUNITY AND REGION

Suspended in a COVID plateau phase are most of the U.S. and Paris. Our infection rates are much better but not at the cut-off level indicating that the risk of transmission reduced enough for abandoning precautions.
Several of the positive tests at the health department this week were re-infections. Community clinics have seen a rise in COVID pneumonia this week as well. The hospital was down to one or two COVID inpatients a week or so ago, but over the last week, we have had four to six COVID patients in house daily and had some COVID deaths this month after having none for a while.

VACCINE
CDC masking recommendations were pulled back a tiny bit this week with the suggestion that fully vaccinated people two weeks out from their vaccination can be maskless if outside and not in large groups of other people. Please continue masking when around non-vaccinated people, practice good hand hygiene and keep your distance from others. It helps lower rates of spread in the community until our vaccination rate is higher.

We still think vaccination is the road back to normalcy. The Paris Lamar County Health District hub will switch to a smaller venue as we see what the nation is seeing, a decrease in vaccine update in rural areas. If we do not achieve a 70% infection rate or vaccination, we will continue as we are now, with mini breakouts that continue indefinitely. The U.S. was averaging about 55,000 new cases a day compared with 66,000 a day last week. Earlier this week, 37.3% of U.S. adults had received a COVID vaccine. When Israel passed 40% vaccination rates, they saw a sharp decline in new cases.

The FDA approved Johnson and Johnson for use again, with a reported rare development of antibodies against platelet factor four causing blood clots in women under 50. Overall, vaccine hesitancy relates in part to fertility concerns despite the social media post that started the problem now debunked, and in part to the general situation from people “not wanting to be guinea pigs.” I encourage community members that the vaccine is safe and is the way for us to be around each other again safely. The health district has had several outreach programs and is happy to work with groups to bring the vaccine into the community and get life-saving shots into arms.

The COVID vaccines developed by Pfizer and Moderna were 94 percent effective at preventing hospitalizations in people 65 years and older who have vaccinated per the Morbidity and Mortality Weekly Report from the CDC. Researchers looked at 417 patients admitted to 24 hospitals in 14 states between January 1 and March 26 and compared those who had received COVID vaccines with those who had not. Among adults older than 65 who had received both vaccine shots at least two weeks previously, the risk of hospitalization from COVID dropped by 94 percent. Adults 65 and older who were partially vaccinated and had received only one shot at least two weeks before their admission had their hospitalization rates drop 64 percent. The CDC found no meaningful difference in hospitalization rates among people who had elapsed less than two weeks since their first vaccine dose. It highlights the continued risk for severe illness shortly after vaccination before achieving a protective immune response.

NATIONAL/GLOBAL UPDATES
CDC, which has been tracking breakthrough cases since February, on Wednesday said roughly 5,800 people vaccinated against the coronavirus have subsequently contracted the virus, with about 396, or seven percent, requiring hospitalization and 74 people passing away.
About 29 percent of the infections were asymptomatic. According to CDC, the data hasn’t revealed any “unexpected patterns in case demographics or vaccine characteristics.” However, the agency noted that reports of breakthrough cases were among all people of all ages eligible for vaccination. A little over 40 percent of the infections were in people 60 or more years of age. Receiving the COVID vaccination has improved symptoms in about 30 percent of long-hauler patients. India reports daily new cases over 300,000, breaking world records daily (The U.S. was over 100,000 cases daily in our Dec/Jan surge). A combination of reducing precautions at the same time surge of variants started spreading in India is thought to be the reason behind their rise in cases.
Forty percent of their cases are in people 26-44 years old, with a 10 percent death rate. They see the U.K. B.1.1.7 variant, the Brazilian P.1 variant, and a different “double mutant” variant, thought to be more infectious and less susceptible to the immune response. This double mutant had been detected in 20 cases in the U.S. by late March.

TESTING & TREATMENTS
Requesting testing for COVID variants in Texas has not proved to be simple, and locally we have not had many tested for variants. For regular testing, PRMC can perform a rapid PCR or antigen with a doctor’s order at registration, and PJC and the health department are still offering free antigen testing. Primary care doctors and local pharmacies also have made testing available.

We do still have monoclonal antibody infusions at PRMC. While we are not running the antibody infusion clinic regularly due to decreased demand, we can schedule an infusion if we have a referred patient who would benefit.

Please continue to take care of each other by wearing a mask, keeping social distance, and practicing good hygiene. Hopefully, we can keep our rates falling a little bit longer. In that case, we can prevent our vulnerable community members from getting sick before completely being done with this phase of the pandemic.